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DSES Logo
eScrip Logo

Join the original and largest electronic fundraising program where participating merchants contribute each time you make a purchase using your debit/credit cards that are registered with eScrip. There is not cost to you! There are not receipts to collect, no vouchers or certificates to buy and not hassles for you. Every purchase counts!!!

Sign Up for eSCRIP Logo  TODAY!!!!!
Group Name

Disabled Sports Eastern Sierra
Group ID #

50000 1307

Register ONLINE: Visit: www.eScrip.com(only one week processing)

Register BY MAIL: If you do not have internet access, fill in the following information.
* Required information

Step 1      
*Last Name  *First Name   
*Address     
*City  *State  *Zip 
E-mail Address  Phone   

New eScrip supporter		 *Please check applicable boxes
Current eScrip supporter _______________________

EScrip Supporter #


Changing Designation Group
Adding Designated Group

Step 2
CARD TYPE CARD NUMBER EXP. DATE
           
           
           
           

Debit/Credit Card Types: Macy’s, MasterCard, Visa, American Express, Discover, Debit Cards
Step 3

Mail completed form to:
eScrip
P.O. Box 6988, Auburn, CA 95604
(Allow 4-6 weeks for processing)

For eScrip Program Information, Merchant Lists or to sign up online, visit: www.escrip.com

Electronic Scrip Incorporation (ESI) has made a firm commitment to protect all customer information provided. ESI will not license, sell, exchange or distribute any personally identifying information about eScrip participants to any third parties not directly involved with the eScrip.
Visit: www.escrip.com for complete terms and conditions.